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Can you get Social Security Disability Benefits for Irritable Bowel Syndrome

Can you get Social Security Disability Benefits for Irritable Bowel Syndrome
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Irritable bowel syndrome (IBS) is a chronic disorder affecting the large intestine. More women than men are diagnosed with IBS, especially women in their 30s and 40s who have a family history of the disorder. However, teens and young adults can get IBS as well.

Symptoms of IBS vary in severity. Mild IBS is manageable and should not impede a person’s ability to work and earn a living. Severe IBS symptoms rarely respond to standard treatments and will negatively impact an individual’s ability to maintain employment. These symptoms include:

  • Unexpected episodes of explosive diarrhea
  • Alternating cycles of diarrhea and constipation
  • Abdominal pain and cramping that worsens after eating
  • Excessive bloating and gas
  • Difficulty urinating/incontinence
  • Dehydration caused by diarrhea and occasional vomiting
  • Anemia/malnutrition
  • Weight loss/problem gaining weight
  • Lack of sleep due to nighttime diarrhea
  • Rectal pain/bleeding

While the exact cause of irritable bowel syndrome isn’t known, doctors speculate the disorder emerges from a combination of several medical issues involving abnormal contractions of the intestinal muscles, inflammation of the intestines and nervous system dysfunction. Some research has also indicated IBS occurs when an imbalance of gut microflora (“good” and “bad” bacteria) alters normal gastrointestinal processes.

Mild IBS is treated by making dietary changes and taking medications that relax intestinal muscles, reduce diarrhea and relieve constipation. Alternative therapies such as psychotherapy, acupuncture and taking probiotic supplements may also help decrease symptoms.

Does the Social Security Administration View Irritable Bowel Syndrome as a Disability?

The SSA’s Blue Book of Medical Conditions lists IBS under Digestive System impairments (Section 5.00). Although the SSA calls IBS “inflammatory bowel disease”, the two clinical terms refer to the same disorder. The SSA states that IBS could  “cause complications such as obstruction and/or co-occur with manifestations in other systems”.

The SSA does consider IBS as a potentially disabling condition warranting monthly disability benefits. To be approved for IBS disability, you must submit documentation that clearly proves the following:

  • A clinical diagnose determined by imaging scans, biopsy, endoscopy or operative conclusions
  • Obstructions in the colon or small intestine that required hospitalization for surgery or intestinal decompression. Hospitalizations must have occurred two or more times in one year, with each hospital stay separated by at least 60 days.

The SSA also accepts the following from IBS patients applying for disability if they do not have small intestine obstructions:

  • Anemia (hemoglobin tests must show less than 10.0 g/dL)
  • A test result of less than 3.0 gdL for serum albumin
  • Clinical documentation of severe abdominal cramping and pain that cannot be relieved with prescription medications
  • Perineal disease accompanied by draining fistula or abscess
  • Weight loss of 10 percent or more (based on BMI indexes)
  • Necessity for daily supplemental nutrition via a venous catheter or gastronomy

When evaluating a disability claim for IBS or any other medical issue, the SSA will carefully examine all medical documentation, including physician reports regarding the applicant’s physical and mental abilities in relation to employment possibilities. If you are applying for SSI or SSDI for irritable bowel syndrome, be aware the SSA considers how long you can sit, stand or walk without experiencing difficulty as well as how capable you are of lifting, pushing and carrying weighted items. SSA evaluators will also take into account when you were initially diagnosed with IBS, how much work you have missed due to IBS symptoms (if you are still employed) and how well you have responded to various treatments.

How Do I File for IBS Disability Benefits?

The SSA accepts disability applications in person, over the phone or online. You will need to make an appointment with the SSA office nearest your location to apply. You do not need an appointment when you apply online or by phone.

After you have submitted your disability claim, the SSA will review the application and all accompanying documents. They may contact you if they have questions about the claim or request additional information before they continue processing the application.

Once a decision is made, the SSA will send a letter either approving or denying your claim. You will not be contacted via email or phone by the SSA when a decision is reached.

In addition to medical documents proving you have been diagnosed with IBS, you will also need to include a copy of your birth certificate, military discharge papers if you were in the military prior to 1968 and tax returns for the previous year (if applicable). Individuals not born in the U.S.will have to include proof of citizenship in their application packet (passport, certificate of naturalization or citizenship).

Checking the status of your application can be done online by logging into your SSA account or by calling 1-800-772-1213.

Why Would My IBS Disability Application Be Denied by the Social Security Administration?

Irritable bowel syndrome is one of many medical conditions the SSA is disinclined to approve for disability benefits. However, people with severe IBS are typically approved for SSDI or SSI after appealing an initial denial with the assistance of an experienced disability attorney. A primary reason for denying disability applications is that the SSA has not been given sufficient documentation proving a person’s IBS symptoms will continue to be chronically debilitating. Since mild to moderate IBS symptoms tend to come and go, the SSA will not approve disability applications from people with intermittent symptoms.

If the SSA does deny your IBS claim, it is probably due to one or more of the following:

  • SSA determined you can still perform work you have done in the past
  • SSA determined you can perform work that you have not done in the past (for example, someone who previously worked on an auto assembly line but had to quit because of IBS may be able to find work that allows them to take frequent breaks)
  • Your age and education level. People over 50 who do not have a college degree are approved for disability much more often than younger individuals with college degrees
  • Your application failed to provide sufficient medical documentation proving you can no longer work due to IBS

How Do I Appeal a Denial for IBS Disability Benefits?

An appeal (reconsideration) should be filed as soon as a letter of denial is received. You only have 60 days from the time you receive a denial letter before you can no longer file an appeal. Do not file a new claim if you have been denied. The SSA will deny it again and it could significantly delay the appeals process. However, if you miss meeting the 60-day deadline, you should then file a new disability claim.

Any new medical evidence you have that proves your IBS is worsening or not responding to treatment should be brought up at the reconsideration appeal stage. It is possible you could get approved at this point if new documentation shows considerable deterioration of your health. However, most reconsideration appeals are denied and must be taken to the next stage of the appeals process.

In most cases, appeals claims are decided within three to four months of being received by the SSA. Getting an appeal approved means you will shortly begin receiving monthly disability benefits.

Denied appeals are allowed to be appealed again within 60 days of the decision. This time, you must request an appeals hearing that is held before an administrative law judge (ALJ). These “second appeal” hearings are heard by a judge who knows nothing about your case. The Social Security Administration gives you the choice of attending the hearing in person or attending the hearing via video. Before an ALJ decides to approve or deny your appeal, they examine your original application and all documentation included in your application to determine if administrative mistakes were made. You cannot submit new medical documents at the ALJ stage of the appeals process.

Be aware that it could take as long as six to nine months to get an ALJ hearing scheduled and another several months after the hearing is over to receive the judge’s determination.

When Should I Contact a Social Security Disability Lawyer?

Certain medical conditions are almost always approved initially for disability by the SSA, such as aggressive cancers, early onset Alzheimer’s disease, acute leukemia, severe developmental disorders and serious mental illnesses. Any medical condition that does not present immediately debilitating symptoms resistant to treatment is likely to be denied for disability benefits.

If your IBS disability application has been denied for the first time, consider hiring a disability lawyer to handle the reconsideration phase of the appeals process. Filing appeal after appeal, especially when you reach the Appeals Council or Federal Court appeal stage, involves completing and filing extensive paperwork with the courts while trying to deal with the financial stress of being unable to work. Social Security disability lawyers have worked with the SSA and know exactly what SSA evaluators are looking for when it comes to approving a disability claim.

Disability lawyer Joel Thrift will ensure you receive a fair hearing, file appeals that skillfully challenge denials and significantly expedite the time it takes to get an approval so you can start receiving your disability benefits. If you have irritable bowel syndrome and can no longer work, call Joel Thrift today to schedule an appointment.

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